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Arthralgia as the initial manifestation of malignant lymphoma

✍ Scribed by Toshihiko Ando; Kenji Shinohara; Jun Nomiyama; Masaaki Toyosawa; Hirofumi Inoue

Publisher
John Wiley and Sons
Year
1995
Tongue
English
Weight
133 KB
Volume
50
Category
Article
ISSN
0361-8609

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✦ Synopsis

Letters and Correspondence

hyperuricemia, mild proteinuria, and a low concentrating ability, as UOsm was low (295 mOsmikg) and was slightly increased after an overnight water restriction (348 mOsm/kg).

The presence of hyperkalemic metabolic acidosis with a normal serum anion gap and an increased urine anion gap and the low values of both PRA and serum aldosterone levels observed before and after volume contraction confirmed the diagnosis of renal tubular acidosis type IV due to hyporeninemic hypoaldosteronism [5], a manifestation described in SS patients, but not in S/p-thal patients [l]. However, although the urine pH in this disorder is generally below 5. 3 [4], in our patient pH was somewhat higher. It is highly likely that the patient had also a hyperkalemic renal tubular acidosis type I, which has been described in patients with sickle cell disease as well [I].

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